Abstract:
INTRODUCTION:The utilization of laparoscopy in colorectal surgery is increasing. However, conversion to open surgery remains relatively high. OBJECTIVE:We evaluated (1) conversion rates in laparoscopic colorectal surgery; (2) the outcomes of converted cases compared with successful laparoscopic and open colorectal operations; (3) predictive risk factors of conversion of laparoscopic colorectal surgery to open surgery. METHODS:Using the National Inpatient Sample database, we examined the clinical data of patients who underwent colon and rectal resection from 2009 to 2010. Multivariate regression analysis was performed to identify factors predictive for conversion of laparoscopic to open operation. RESULTS:A total of 207,311 patients underwent intended laparoscopic colorectal resection during this period. The conversion rate was 16.6 %. Considering resection type and pathology, the highest conversion rates were observed in proctectomy (31.4 %) and Crohn's disease (20.2 %). Using multivariate regression analysis, Crohn's disease (adjusted odds ratio [AOR], 2.80), prior abdominal surgery (AOR, 2.45), proctectomy (AOR, 2.42), malignant pathology (AOR, 1.90), emergent surgery (AOR, 1.82), obesity (AOR, 1.63), and ulcerative colitis (AOR, 1.60) significantly impacted the risk of conversion. Compared with patients who were successfully completed laparoscopically, converted patients had a significantly higher complication rate (laparoscopic: 23 %; vs. converted: 35.2 % vs. open: 35.3 %), a higher in-hospital mortality rate (laparoscopic: 0.5 %; vs. converted: 0.6 %; vs. open: 1.7 %) and a longer mean hospital stay (laparoscopic: 5.4 days; vs. converted: 8.1 days; vs. open: 8.4 days); however, converted patients had better outcomes compared with the open group. CONCLUSIONS:The conversion rate in colorectal surgery was 16.6 %. Converted patients had significantly higher rates of morbidity and mortality compared to successfully completed laparoscopic cases, although lower than open cases. Crohn's disease, prior abdominal surgery, and proctectomy are the strongest predictors for conversion of laparoscopic to open in colorectal operations.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Masoomi H,Moghadamyeghaneh Z,Mills S,Carmichael JC,Pigazzi A,Stamos MJdoi
10.1007/s00268-015-2958-zsubject
Has Abstractpub_date
2015-05-01 00:00:00pages
1240-7issue
5eissn
0364-2313issn
1432-2323journal_volume
39pub_type
杂志文章abstract:BACKGROUND:The retained knife blade is an unusual and spectacular injury. The aim of this study was to review our experience with the management of such injuries. METHODS:A retrospective chart review of patients with retained knife blades treated at Groote Schuur Hospital Trauma Centre from January 1996 to December 20...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0514-4
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Thoracoscopic repair of esophageal atresia is considered to be one of the more advanced pediatric surgical procedures, and it undoubtedly has a learning curve. This is a single-center study that was designed to determine the learning curve of thoracoscopic repair of esophageal atresia. METHODS:The study inv...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1651-8
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant treatment, remains cont...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3908-8
更新日期:2017-07-01 00:00:00
abstract::Little evidence is available regarding long-term survival of patients with gallbladder cancer that is discovered at the time of laparoscopic cholecystectomy (LC). Therefore the present study was performed to evaluate long-term outcomes of this disease. Of 1546 patients who underwent LC for benign gallbladder disease b...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7886-x
更新日期:2005-09-01 00:00:00
abstract::The role of the tumor suppressor gene p53 and proto-oncogenes mdm-2, waf-1,and bcl-2 in sporadic colorectal carcinoma (CRC) has been well investigated. However, little is known about the role of these genes in the development of ulcerative colitis-associated colorectal carcinoma (CAC). Colectomy specimens from patient...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0237-7
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobs...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0007-5
更新日期:2009-06-01 00:00:00
abstract::Extracorporeal life support has evolved considerably over the past two decades. Once considered as salvage or experimental therapy in adults, extracorporeal membrane oxygenation (ECMO) is evolving into a mainstream treatment for adult critical care. This is especially true in trauma and high-risk surgical patients, wh...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-016-3586-y
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Intense disease surveillance and frequent lymph node metastases (LNMs) in papillary thyroid cancer (PTC) have resulted in increased locoregional recurrences. We examined the safety and efficacy of an optimized surgical approach including preoperative ultrasonography (US), bilateral thyroidectomy, routine com...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0307-9
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. METHODS:A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05199-1
更新日期:2020-01-01 00:00:00
abstract::A review of the literature describing the management of hepatic and splenic injuries indicates that as many as 67% of exploratory celiotomies for blunt trauma are reported as nontherapeutic. Avoiding unnecessary surgery through nonoperative management offers an attractive alternative. Nonetheless, nonoperative managem...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0138-9
更新日期:2001-11-01 00:00:00
abstract::Surgical resection remains the therapy of choice for the treatment of potentially curable gastrointestinal tract (GI) malignancies. Many of these tumors are incurable at the time of diagnosis and therapy should be directed towards palliation with the intent of minimizing pain, bleeding, obstruction, and potential morb...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067061
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The recent development and spread of ultrasonography and ultrasonography-guided fine needle aspiration biopsy (FNAB) has facilitated the detection of small papillary microcarcinomas of the thyroid measuring 1 cm or less (PMC). The marked difference in prevalence between clinical thyroid carcinoma and PMC det...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0303-0
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Concerns remain unresolved regarding the safety of unplanned conversion to open thoracotomy during video-assisted thoracic surgery (VATS) lobectomy. We analyzed both early and late outcomes after thoracotomy conversion from VATS. METHODS:From December 2003 to December 2008, a total of 738 VATS lobectomies w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0913-6
更新日期:2011-03-01 00:00:00
abstract::Although peptic gastroduodenal ulcers are rarely treated surgically today, when surgery is required a laparoscopic approach is possible with its well known advantages. The most widely used technique is vagotomy by various modalities. Training in laparoscopy requires good instrumentation to avoid complications. Vagotom...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910044
更新日期:2000-03-01 00:00:00
abstract::Distinguishing cellular follicular adenomas (FA) from minimally invasive follicular carcinomas (FC) continues to plague even experienced thyroid pathologists. DNA ploidy analysis has been promoted as a means of making this differentiation; however, the finding of DNA aneuploidy in FA has caused concern that they may d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658504
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Thymic epithelial tumors are characterized by slow growth and variable malignant behavior. We present our experience on the surgical management of these tumors. MATERIALS AND METHODS:We conducted a retrospective analysis of patients with thymomas undergoing modified maximal thymectomy over a period of 16 ye...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0097-0
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Molecular diagnostics can allow some patients with indeterminate thyroid nodule cytopathology to avoid diagnostic hemithyroidectomy; however, the testing is costly. We hypothesized that molecular testing with the intention of preventing unnecessary diagnostic hemithyroidectomy would be cost-effective if this...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05177-7
更新日期:2020-02-01 00:00:00
abstract::This study was first designed to investigate systematically the kinetics of surface expression of scavenger receptors (SRs) and CD14 on alveolar macrophages in vivo and in vitro and their relation with local pro- and antiinflammatory responses in endotoxemia. The expression of SR and CD14 in lungs was down- and up-reg...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6548-5
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resectio...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4423-7
更新日期:2018-07-01 00:00:00
abstract::Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis....
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00268-001-0067-7
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The evolution of diagnostic procedures has resulted in an increase in early detection of pathologically T1 (pT1) colorectal cancer (CRC). However, the risk factors affecting long-term outcomes of patients with pT1 CRCs have been unclear. The aim of the present study was to identify risk factors for postopera...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1378-y
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The optimal timing of VTE prophylaxis initiation after blunt solid organ injury is controversial. Retrospective studies suggest initiation ≤48 h is safe. This prospective study examined the safety and efficacy of early VTE prophylaxis initiation after nonoperative blunt solid organ injury. METHODS:All patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05096-7
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) is a condition that has always been perceived to be rare in Asia. The aim of this systematic review was to gather the current available evidence on the incidence of VTE in this population. A secondary aim was to assess the efficacy of pharmacological prophylaxis, and hence determ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2763-0
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:The use of pulmonary artery catheter (PAC) is controversial. The purpose of this study was to document the changing pattern of PAC use and to determine its effect on outcome. METHODS:The use of PAC was analyzed in patients ≥16 years old admitted to the surgical intensive care unit (SICU) over a 9-year period...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1149-9
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The extrahepatic surgical technique in liver resection can be divided into glissonean pedicle transection and glissonean separated transection approaches. In this study, we compared remnant liver function and liver regeneration involving the Spiegel lobe between these two approaches regarding Spiegel lobe-pr...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05548-5
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Human factors research has suggested benefits of consistent teams yet no surgical team consistency measures have been established for teamwork improvement initiatives. METHODS:Retrospective analysis was conducted of teams performing consecutive elective procedures of unilateral primary total knee and hip re...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2866-7
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Splenic trauma is a common organ injury following blunt abdominal trauma. In order to establish the contemporary epidemiology of blunt splenic trauma in Scotland and to detect risk factors associated with patient outcomes, analysis of a multi-center database of trauma patients was performed. METHODS:The stu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9218-9
更新日期:2007-11-01 00:00:00
abstract::We conducted a prospective case series study to investigate the causes of and factors influencing morbidity and mortality in 102 consecutive patients after elective infrarenal abdominal aneurysm (AAA) surgery between 1992 and 1995. Preoperative factors (demographics, risk factor indexes, electrocardiographic findings,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900382
更新日期:1998-03-01 00:00:00
abstract::The most appropriate approach to treating hepatocellular carcinoma (HCC) in the caudate lobe has not yet been determined. A series of 197 patients who had undergone curative hepatic resection for HCC were analyzed. Fifteen patients had HCC in the caudate lobe: three in the Spiegel lobe (SP), three in the caudate proce...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7341-4
更新日期:2004-07-01 00:00:00
abstract:INTRODUCTION:Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9469-0
更新日期:2008-07-01 00:00:00